Individual
OMOTOOKE OLUSEYI BABALOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
587 SKYLINE DR, JACKSON, TN 38301-3938
(731) 422-7900
Mailing address
22 MCKINLEY CV, JACKSON, TN 38305
(347) 313-5850
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
69737
TN
207RP1001X
Pulmonary Disease Physician
Primary
69737
TN
Other
Enumeration date
04/16/2018
Last updated
06/28/2024
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